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{�. SAN JOAQUIN COUNTY <br /> = ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ' Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PERCOLATION TEST RATE <br /> ADDRESS OR LOCATION: /fin f30 /VQ)2W ST aT. �� �D/VTAG C CITY: 5:02 d -5 p 1 a2 <br /> OWNER NAME: HA aA e,LF— 4-U zci4 DATE: I pne Yyl P,F-z 'xt a 0.2a <br /> APN: (��.},(o -©7D-.4-7 APPLICATION#: DEPTH TO FIRST WATER: /010 Ft <br /> SOIL TYPE: ,/P� / l <br /> REMARKS: NCL" LI Q Nf D 1 Q 4WAT-Er1e Arrl JL N�L P IES�SD,Q GG <br /> LOCATION OF TEST HOLES (SHOW WELLS AND STRUCTURES) <br /> a , <br /> I <br /> __..... _ .._.._ � _ <br /> ........._� 7_.._ g ........._� - -� - - }— j - --f—j ---9—t- <br /> 1 t 1 1 i 9 k I I B 1 c i f i 1 3 <br /> ........ <br /> ..................... <br /> ........ <br /> ............ <br /> _.. _ I .. I I <br /> .... <br /> ............. <br /> £ -�--.�-y,-�---y�r S 3 €�- E- <br /> 1p i 1114 <br /> f <br /> { 1 ! E 13 <br /> I i 1 I ( 1 1 i I I E 1 I 1 1 1 <br /> r a <br /> I I I t i--�....i � � I I 1 � <br /> - -- <br /> I I <br /> SOIL PROFILE(IF REQUIRED) <br /> Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type Depth Soil Type <br /> Test Hole# 1 Test Hole#2 <br /> Parcel: Diameter: S in Depth: z in Parcel: Diameter: in De the pin <br /> TIME READING WATER DROP REFILLED TIME READING _WATER DROP REFILLED <br /> 3. a " 3 <br /> ' or <br /> 0 3 _ <br /> j '- DS 0 ._ <br /> PERCOLATION RATE: D, min/in PERCOLATION RATE: SD,0 min/in <br /> RECOMMENDED SEPTIC EA: PO RECOMMENDE9 SEPTIC AREA: <br /> TEST PERFORMED BY: Phone: O 2 -/loS Date <br /> TEST CERTIFIED BY: salt Phone: Date <br /> OBSERVED BY (RENS): Phone Date ° <br /> EHD 42-03 REV 11/2/09 PERC TEST RATE FORM <br />